Knee Surgery and Related Research最新文献

{"title":"Simulation of realistic patella fractures: an investigation into the mechanism and potential benefit for surgical training.","authors":"Sebastian Wegmann, Jannik Leyendecker, Tim Leschinger, Maximilian Weber, Lars-Peter Mueller, Andreas Harbrecht","doi":"10.1186/s43019-025-00281-6","DOIUrl":"10.1186/s43019-025-00281-6","url":null,"abstract":"<p><strong>Introduction: </strong>Patella fractures account for about 1% of all bone fractures, predominantly affecting males at a 2:1 ratio and exhibiting distinctive age-related patterns. In younger individuals, these injuries typically result from high-velocity impacts, while in the elderly, they usually arise from lower-energy impacts. Consequently, the types of fractures differ; horizontal fractures are more common in younger individuals, whereas comminuted fractures are more prevalent in older adults. Owing to the knee's biomechanics, surgical intervention is often necessary. Preserving the articular surface is crucial to prevent retropatellar osteoarthritis, making thorough planning of surgical treatment essential. How can the osteosynthesis of this fracture entity be simulated as realistically as possible?</p><p><strong>Materials and methods: </strong>This study focused on the feasibility of inducing realistic patella fractures with an intact soft tissue envelope on human cadaveric specimens for surgical training purposes. A total of seven fresh-frozen human cadaveric knee joints were used, and fractures were created using a custom-designed drop-test bench. The induced fractures were then classified according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) and Speck and Regazzoni classifications using radiographic and computed tomography (CT) evaluations. In addition, intra-rater and inter-rater reliability were further examined.</p><p><strong>Results: </strong>All specimens were successfully fractured. The results demonstrated high intra-rater and inter-rater reliability in both fracture classification systems, indicating that the method can reliably replicate realistic fractures for training purposes.</p><p><strong>Conclusions: </strong>The study highlights the significance of using specimens with realistically induced fracture patterns in surgical education. Given that patella fractures are relatively rare and limit direct clinical exposure, realistic fracture models are invaluable for understanding these conditions. These models enhance surgical training, enabling both novice and experienced surgeons to refine their skills and effectively adapt to new surgical techniques.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A network meta-analysis evaluating valgization high tibial osteotomy cutting guides: improving surgical precision through navigation and PSI.","authors":"Fanny Delaigue, Hassan Wardani, Jules Descamps, Matthieu Ollivier, Rémy Nizard, Pierre-Alban Bouché","doi":"10.1186/s43019-025-00278-1","DOIUrl":"10.1186/s43019-025-00278-1","url":null,"abstract":"<p><strong>Background: </strong>A total of three techniques are used to guide tibial cuts in high tibial osteotomy (HTO): the conventional method, navigation systems, and patient-specific instrumentation (PSI). This network meta-analysis sought to assess whether any of these methods achieve better radiological outcomes, greater functional gains, or a reduced rate of complications.</p><p><strong>Design: </strong>We included all controlled and noncontrolled trials comparing at least two of the surgical techniques. Primary outcomes were rates of medial proximal tibial angle (MPTA) and posterior tibial slope (PTS) outliers. Secondary outcomes included the rate of hip-knee-ankle (HKA) angle outliers, joint range of motion, postoperative clinical scores, and complication rates.</p><p><strong>Results: </strong>The analysis included 24 studies with 1817 patients and 1951 operated knees. PSI did not reduce the rate of MPTA outliers compared with conventional techniques (95% credible intervals, CI [0.09-56.84]) or navigation (95% CI [0.03-25.62]), and navigation did not reduce the rate compared with conventional methods (95% CI [0.84-9.17]). Navigation reduced the rate of PTS outliers compared with conventional techniques (95% CI [1.93-1.56.10⁴]). No study investigating PTS outliers with PSI was identified or included. Both navigation and PSI reduced the rate of HKA angle outliers (95% CI [1.33-3.16] and [1.15-42.61], respectively). Aside from the rate of HKA angle outliers and the Lysholm score between 1 and 2 years postoperatively, no differences were observed for other outcomes.</p><p><strong>Conclusions: </strong>Navigation and PSI allow for more precise achievement of the PTS and HKA angle values set by the surgeons but do not affect long-term knee function or complication rates. However, the cost and limited availability of these techniques should be considered, especially in the absence of additional functional benefits.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractures with complex fracture patterns are associated with increased rate of subsequent conversion to total knee arthroplasty after a tibial plateau fracture: an observational cohort study of 12,012 patients from the Swedish Fracture Register.","authors":"Fredrik Olerud, Anne Garland, Nils P Hailer, Olof Wolf","doi":"10.1186/s43019-025-00279-0","DOIUrl":"10.1186/s43019-025-00279-0","url":null,"abstract":"<p><strong>Background: </strong>Tibial plateau fractures (TPFs) can be associated with development of significant joint degeneration, which can lead to functional impairment and pain severe enough to necessitate conversion to total knee arthroplasty (TKA). The factors influencing the progression to TKA after TPF, including preoperative fracture and patient characteristics, remain unclear. This study aimed to assess the national conversion rate to TKA following TPF depending on fracture type.</p><p><strong>Patients and methods: </strong>The cohort consisted of all patients aged 18 years and older at time of injury with a TPF registered in the Swedish Fracture Register (SFR) between 2012 and 2023. The SFR holds information on baseline patient characteristics including fracture classification according to the AO/OTA system. Conversion to TKA was identified through linkage with the Swedish Arthroplasty Register (SAR). Kaplan-Meier survival analyses investigated conversion rate. Cox regression was performed to assess association between fracture type and TKA conversion adjusted for age, sex, and injury energy level. The follow-up period ranged from 0 to 12 years, with a mean of 4.2 years.</p><p><strong>Results: </strong>A total of 12,012 patients with a mean age of 57 years were included; 63% were women. The observed conversion rate after 5 years was 2.8% in all patients and 4.1% in surgically treated patients. The conversion rate at 5 years was highest in the 65-74 years age group with 5.2%. Fractures with comminuted fracture patterns, particularly AO/OTA 41B3, 41C2, and 41C3, were associated with significantly increased risks of conversion, with adjusted hazard ratios (aHRs) of 2.1 (95% CI 1.3-3.3), 2.3 (1.2-4.5), and 3.2 (95% CI 2.0-4.5), respectively. High-energy trauma did not increase the risk of conversion, nor did sex. Increasing age was associated with an increased risk of conversion up to the age of 84, while age over 85 was not.</p><p><strong>Conclusions: </strong>Fractures with complex fracture patterns, particularly AO/OTA 41B3, 41C2, and 41C3, were associated with an increased TKA conversion rate following TPF. The conversion rate increased with increasing age, but sex and high-energy injury mechanisms did not affect conversion rate. On a national level, 3% of patients were converted to TKA within 5 years of sustaining a TPF, and 4% of patients treated surgically. This may help surgeons when counseling patients with TPFs.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and quantification of ipsilateral and contralateral ankle joint alignment changes after unilateral total knee arthroplasty for knee osteoarthritis with varus deformity: a retrospective cohort study.","authors":"Ahmed A Khalifa, Amr A Fadle, Abdelrahman A Aziz Khalaf, Ahmed M Abdelaal, Mohamed M A Moustafa","doi":"10.1186/s43019-025-00277-2","DOIUrl":"10.1186/s43019-025-00277-2","url":null,"abstract":"<p><strong>Purpose: </strong>The study's primary objective was to assess and quantify the ipsilateral (side A) and contralateral (side B) ankle joint line orientation (AJLO) changes after unilateral total knee arthroplasty (TKA) for primary knee osteoarthritis (OA) with varus deformity. The secondary objectives were to detect if there was a correlation between the knee deformity correction and AJLO changes and if the knee and ankle clinical outcomes on the TKA side correlate with joint alignment changes.</p><p><strong>Methods: </strong>This retrospective cohort study included 70 patients with a mean age of 61.76 ± 5.96 years. The lower limb alignment was evaluated using the hip-knee-ankle (HKA) angle, while the AJLO was assessed using the tibial plafond to horizontal line angle (TPHA). The functional outcomes for side A were evaluated at a median follow-up of 18 (interquartile range (IQR): 12-46.2) months using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and The American Orthopaedic Foot and Ankle Society (AOFAS) score for the knee and ankle joints, respectively.</p><p><strong>Results: </strong>In side A, the HKA significantly improved from 167.49 ± 6.25 to 177.08 ± 4.39 (p < 0.001). No difference in AJLO was found between both sides preoperatively (p = 0.329). At the last follow-up, in side A, the AJLO changed significantly into less varus from -7.11 ± 5.44° to -1.10 ± 4.91° (p < 0.001); in side B, the AJLO showed no significant changes (-6.38 ± 6.10° versus -6.65 ± 6.50°, p = 0.970). For side A, the KOOS and AOFAS showed significant improvement, 45.20 ± 14.94 versus 75.72 ± 13.28 (p < 0.001) and 70 (65-75) versus 90 (80-90; p < 0.001), respectively. The preoperative HKA and AJLO on side A and side B showed significant positive correlations (r = 0.591, p < 0.001 and r = 0.611, p < 0.001, respectively). On side A, the postoperative HKA and AJLO showed a significant positive correlation (r = 0.298, p = 0.012). The preoperative and postoperative AJLO and AOFAS on side A showed nonsignificant negative correlations (r = -0.202, p = 0.277 and r = -0.115, p = 0.537, respectively). The preoperative and postoperative HKA and AOFAS on side A showed nonsignificant positive correlations (r = 0.126, p = 0.499 and r = 0.331, p = 0.069, respectively). The linear regression analysis indicated that for every 1° correction in HKA, the AJLO changed by 0.5° (R² = 0.241, 95% confidence interval (CI) 0.298-0.747, p < 0.001).</p><p><strong>Conclusions: </strong>The ipsilateral ankle joint realigned to a less varus position after ipsilateral TKA for managing knee OA with varus deformity, with an estimated half a degree of less varus AJLO after HKA correction by a degree. No changes occurred in the contralateral ankle joint. The ankle joint function improvement was not correlated to the HKA or AJLO changes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision of unicondylar knee arthroplasty: an analysis of failure rates and contributing factors.","authors":"Dominik Szymski, Josina Straub, Nike Walter, Yinan Wu, Oliver Melsheimer, Alexander Grimberg, Volker Alt, Arnd Steinbrueck, Markus Rupp","doi":"10.1186/s43019-025-00276-3","DOIUrl":"10.1186/s43019-025-00276-3","url":null,"abstract":"<p><strong>Background: </strong>The implantation rate of knee arthroplasty and, in particular of unicondylar knee arthroplasty (UKA), is increasing, and revision is a feared complication. The aim of this study was to identify factors influencing aseptic and septic revision that are of high interest for establishing preventive measures.</p><p><strong>Methods: </strong>Data were collected using the German Arthroplasty Registry (EPRD). Patients with UKA were analyzed using the multiple Log-rank test with Holm's method. Septic and aseptic revisions were calculated using Kaplan-Meier estimates. In total, 300,998 cases of knee arthroplasty were identified in the registry, and 36,861 patients with UKA were analyzed with a maximum follow-up of 7 years.</p><p><strong>Results: </strong>The primary reason for UKA revision surgery was aseptic loosening (32.5%), particularly loosening of the tibial component (19.0%), followed by infection (11.0%) and the progression of arthritis (10.0%). Over 7 years, 8.7% of UKA procedures required revision, 7.8% for aseptic causes and 0.9% for infection. Risk factors for aseptic revision included uncemented implants [hazard ratio (HR) 1.38] and low annual surgical volume (fewer than 25 UKAs/year, HR 1.86; fewer than 50 UKAs/year, HR 1.43). Significant risks for septic revision were grade III obesity (HR 1.83), male sex (HR 1.69), and high comorbidity scores (Elixhauser > 5, HR 1.67). The surgical volume did not affect septic revision rates.</p><p><strong>Conclusion: </strong>Aseptic loosening is the primary cause of UKA revision, influenced by implant type and low surgical volume, while septic revisions are associated with patient factors such as obesity, male sex, and comorbidities. Improvements in implant selection, surgical expertise, and patient risk management may reduce revision rates.</p><p><strong>Level of evidence: </strong>III, retrospective case-control study.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateralized position of femoral and tibial components during posterior-stabilized total knee arthroplasty leads to better functional outcomes.","authors":"Shinichiro Nakamura, Yoshihisa Tanaka, Shinichi Kuriyama, Kohei Nishitani, Yugo 侑吾 Morita, Yugo 悠吾 Morita, Sayako Sakai, Yuki Shinya, Shuichi Matsuda","doi":"10.1186/s43019-025-00275-4","DOIUrl":"10.1186/s43019-025-00275-4","url":null,"abstract":"<p><strong>Background: </strong>The mediolateral position and postoperative translation of the femoral and tibial components relative to the respective bones after total knee arthroplasty (TKA) have not yet been investigated. The purpose of the current study was to investigate the effect of the mediolateral position of the femoral and tibial components on clinical outcomes including muscle strength and ambulatory function.</p><p><strong>Methods: </strong>A total of 86 consecutive knees were included. The mediolateral positions of the femoral and tibial components were measured on the postoperative long-leg radiographs. The mediolateral position of the femoral and tibial components was defined relative to the femoral distal anatomical axis and the tibial mechanical axis. The lateral position of the component was denoted as positive. The lateral translation of the femoral and tibial components was defined as the distance between the preoperative femoral and tibial centers and the postoperative center of the respective component. The Knee Society Score (KSS), New Knee Society Score (2011 KSS), and the Timed Up and Go (TUG) test results were evaluated 2 years postoperatively. Spearman's correlation coefficient was calculated.</p><p><strong>Results: </strong>The lateral position of the femoral component was significantly positively correlated with KSS function score (ρ = 0.250, p = 0.020), 2011 KSS functional activities (ρ = 0.258, p = 0.017), and TUG values (ρ = - 0.241, p = 0.027). The lateral translation of the tibial component was significantly correlated with knee extension strength (ρ = 0.259, p = 0.017).</p><p><strong>Conclusions: </strong>The lateralized position of the femoral and tibial components positively influenced postoperative knee function. When the width of the component does not fit the resected surface, a lateralized position of the femoral and tibial components with respect to the respective bones can be recommended for better functional outcomes.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of knee cysts: diagnosis and treatment.","authors":"Mahmod Hasan, Yaron Berkovich, Bilal Sarhan, Yaniv Steinfeld, Eyal Ginesin, Sobhe Hijaze, Ali Sleiman, Yaniv Yonai","doi":"10.1186/s43019-025-00269-2","DOIUrl":"https://doi.org/10.1186/s43019-025-00269-2","url":null,"abstract":"<p><p>Knee cysts are a common finding in orthopedic practice, with diagnoses that range from benign fluid collections to more complex lesions requiring intervention. This comprehensive review explores the types of cysts around the knee, including popliteal (Baker's) cysts, meniscal cysts, proximal tibiofibular joint cysts, and ganglion cysts within the cruciate ligaments. The review highlights the mechanisms of formation, clinical presentations, diagnostic methods, differential diagnoses, and treatments for each cyst type. Imaging, particularly MRI, plays a critical role in accurate diagnosis, helping differentiate cysts from other pathologies, such as tumors and vascular lesions. Treatment options vary, from conservative management for asymptomatic cases to surgical interventions, such as arthroscopic cyst removal, for symptomatic cysts or those associated with intra-articular pathologies. Emerging biological treatments, including platelet-rich plasma (PRP) and mesenchymal stem cell (MSC) therapies, show promise for addressing underlying joint degeneration and inflammation associated with certain cysts, particularly those linked to osteoarthritis. This review underscores the importance of tailored, evidence-based approaches in managing knee cysts to optimize patient outcomes. Keywords: Knee Cysts, Popliteal Cyst, Meniscal Cyst, Proximal Tibiofibular Joint Cyst, Joint Pathology.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-level knee valgization osteotomy has high survivorship and a low complication rate in a single-center series of 58 cases with a mean clinical follow-up of 10 years.","authors":"Ahmed Mabrouk, Michael Risebury, Sam Yasen","doi":"10.1186/s43019-025-00271-8","DOIUrl":"10.1186/s43019-025-00271-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Double-level knee osteotomy (DLO) is becoming more popular in bifocal (femur and tibia deformities) as it addresses the deformity where it belongs and results in a more physiologic joint line obliquity. This study reports on the early to midterm outcomes, both clinical and radiological, of valgization DLO for varus knees and the first study to report the 10-year survivorship of this procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review of a prospectively maintained single-center database of 1170 knee osteotomies was undertaken. Patients with bifocal (femur and tibia) varus malalignment and isolated medial compartment osteoarthritis who had DLO corrections [high tibial osteotomy (HTO) and distal femoral osteotomy (DFO)] were included. Multiple patient-reported outcome measures (PROMs) were recorded preoperatively and serially postoperatively. This included the Knee Injury and Osteoarthritis Outcome Score, the Oxford Knee Score, the Oxford Knee Score-Activity and Participation Questionnaire, the Western Ontario and McMaster University Score, the visual analog scale for health and pain, and the EQ-5D. EQ-5D stands for EuroQol 5-dimension. It is a standardized instrument for measuring health-related quality of life (HRQoL). All lower limb alignment indices were recorded pre-and postoperatively. The rates of osteotomy revision, conversion to arthroplasty, complications, and both 8- and 10-year survivorship were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 58 valgization DLO cases were followed up to a mean of 10.8 ± 3 years. This comprised 74.1% males and 25.9% females, with a mean age of 47.9 ± 9.8 years and a mean body mass index (BMI) of 31.5 ± 6.3 kg/m&lt;sup&gt;2&lt;/sup&gt;. The mean planned correction angles for HTO and DFO were 7.7° ± 2.7° and 7.7° ± 3°, respectively. Postoperatively, the mean mechanical tibiofemoral angle improved from -12.7° ± 3.9° (varus) to -0.4° ± 3.4° (i.e., centered around mechanical neutral), the mean medial proximal tibial angle improved from preoperative 84.3 ± 3.2° to postoperative 90° ± 2.5°, the mean mechanical lateral distal femoral angle improved from preoperative 91.6° ± 3.4° to postoperative 86.7° ± 2.5°, and the mean Mikulicz point improved from -5 ± 13.4% to 47.7 ± 14.7% (all p-values &lt; 0.001). All PROMs significantly improved at 24 months follow-up (all p values &lt; 0.001). The rate of osteotomy revision was 3.4%. The overall rate of total knee arthroplasty conversion was 5.2% at an average of 5.9 ± 3.1 years postoperatively. The complication rate was 8.6%. The 8- and 10-year survivorship was 97.1%, and 94.4%, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this single-center series evaluating patients with varus knees and bifocal deformities, valgization double-level knee osteotomy (DLO) demonstrated favorable clinical outcomes, accompanied by a low complication rate of 8.6% and a 10-year survivorship of 94.4%. Radiographic findings from available imaging data wer","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the anterolateral ligament of the knee: a bibliometric analysis.","authors":"Hale Öktem, Yusuf Jamil, Sinem Nur Sever","doi":"10.1186/s43019-025-00274-5","DOIUrl":"https://doi.org/10.1186/s43019-025-00274-5","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate research trends, key contributors, and thematic focuses in research of the anterolateral ligament (ALL) of the knee. It seeks to identify future direction for studies related to long-term clinical outcomes regarding ALL's role in rotational stability, especially in the context of anterior cruciate ligament (ACL) injuries.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Web of Science (WoS) database, covering publications from 2012 to 2024 with the search term \"anterolateral ligament\". A total of 942 studies were identified. Descriptive statistics summarized publication trends, authorship, institutional contributions, and citation metrics. VOSviewer software was used to analyze co-authorship network analysis, keyword co-occurrence mapping, and total citation analysis. Yearly publication and citation trends were analyzed using WoS data. Studies addressing the ALL in other body regions were excluded. Additionally, only authors with at least one publication and one citation were considered, and documents with more than 25 authors were excluded. A total citation analysis was conducted, and 24 relevant keywords with more than 5 occurrences were identified using VOSviewer.</p><p><strong>Results: </strong>Among 942 publications, 707 were original articles. Research output peaked in 2017 (125 articles). Sonnery-Cottet was the leading author (75 publications), while Universidade De São-Paulo emerged as the top institution (57 publications). Key journals included Arthroscopy: Journal of Arthroscopic and Related Surgery (143 articles) and The American Journal of Sports Medicine (131 articles). Keywords such as \"anterior cruciate ligament\", \"reconstruction\", and \"rotational stability\" dominated, reflecting a focus on ACL injury management. The top ten cited studies accrued 3,86 citations, with Claes et al.'s anatomical study leading (621 citations). Of the 942 ALL-related articles in WoS, 381 focused on anatomy (11,278 citations) while 814 addressed reconstruction (17,048 citations). Keyword trends shifted from anatomical to clinical terms, with anatomy declining and stability, injury, and outcomes gaining prominence from 2021 to 2024.</p><p><strong>Conclusions: </strong>This bibliometric analysis underscores the growing interest in ALL research, peaking between 2016 and 2017. While foundational studies on ALL anatomy and biomechanics appear saturated, future research should prioritize clinical outcomes in terms of failure rate, reoperation, the long-term efficacy of ACL-ALL reconstruction, and advancements in imaging techniques.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboembolic and infectious complication risks in TKA and UKA: evidence from a Japanese nationwide cohort.","authors":"Yu Mori, Kunio Tarasawa, Hidetatsu Tanaka, Masayuki Kamimura, Kento Harada, Naoko Mori, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1186/s43019-025-00273-6","DOIUrl":"https://doi.org/10.1186/s43019-025-00273-6","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are widely used to treat knee osteoarthritis. TKA significantly contributes to long-term pain relief and joint function improvement, while UKA offers faster recovery and reduced early complications. However, TKA and UKA complication risks, aside from conditions such as deep vein thrombosis, have not been thoroughly investigated. This study compares the in-hospital complication risks of TKA and UKA using a nationwide Japanese database.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Japanese Diagnosis Procedure Combination (DPC) database, spanning from April 2016 to March 2023. A total of 259,319 knee arthroplasty cases (TKA: 228,595; UKA: 30,724) were analyzed. Propensity score matching (1:1) was used to adjust for age, sex, comorbidities, and surgical factors, resulting in 30,591 matched pairs. Multivariable logistic regression analyses assessed the risks of complications, including deep vein thrombosis, pulmonary embolism, and surgical site infections.</p><p><strong>Results: </strong>Deep vein thrombosis is frequently observed as a complication with a high incidence rate. Even after propensity score matching, the incidence remained significantly higher in the TKA group (8.8%) compared with the UKA group (6.1%) (p < 0.0001). TKA was associated with significantly higher risks of deep vein thrombosis (odds ratio (OR): 1.467, 95% confidence interval (CI) 1.380-1.560, p < 0.0001), pulmonary embolism (OR: 1.709, 95% CI 1.182-2.470, p = 0.0044), and surgical site infection (OR: 1.512, 95% CI 1.277-1.790, p < 0.0001) compared with UKA. UKA showed lower risks of cognitive dysfunction, pneumonia, transfusion requirements, and shorter hospital stays. However, patients who underwent UKA had a higher risk of periprosthetic fractures.</p><p><strong>Conclusions: </strong>This study highlights the distinct risk profiles of TKA and UKA, emphasizing the need for tailored surgical decision-making. UKA offers advantages in reducing complications for specific patient populations. Strengthening prophylactic measures is crucial for effectively managing thromboembolic and infectious complications in patients undergoing TKA.</p>","PeriodicalId":36317,"journal":{"name":"Knee Surgery and Related Research","volume":"37 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}